Inspection on 27/09/06 for Mulberry Court

This inspection was carried out on 27th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mulberry Court 25/05/07

Mulberry Court 21/11/05

Mulberry Court 17/08/05

Mulberry Court 21/02/05

Mulberry Court 21/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Mulberry Court Common Mead Lane Gillingham Dorset SP8 4RE Lead Inspector Veronica Crowley Unannounced Inspection 27th September 2006 10:00 Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mulberry Court Address Common Mead Lane Gillingham Dorset SP8 4RE 01747 822241 01747 822241 mulberry.court@scope.org.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) SCOPE Care Home 10 Category(ies) of Physical disability (10) registration, with number of places Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person (as known to the CSCI) to be accommodated in the category (LD) Learning Disability. Maximum number registered not to exceed ten. 21st November 2005 Date of last inspection Brief Description of the Service: Mulberry Court provides care and accommodation for 10 people who have physical disabilities. It was registered as a new service in December 1999 to replace the accommodation at nearby Thorngrove House, where 9 of the current service users had lived for some considerable time. The service provider is SCOPE, a national not for profit organisation for people who have a physical disability. The premises are leased from East Dorset Housing Association. Accommodation comprises one bungalow and one two-storey building, with all accommodation for service users provided at ground level. The home is within walking distance of Gillingham town centre; bus routes and the railway station are nearby. Service users at Mulberry Court live as independently as possible. Staffing is arranged to provide daily 24-hour support. The aims and philosophy of the service seek to promote the independence of service users by providing the degree of support necessary to achieve their chosen daily lifestyles, and also by providing opportunities for service users to develop skills that will support independence. A number of service users are described as having some degree of learning disability, and the Commission for Social Care Inspection has agreed a variation to the homes conditions of registration to accommodate one person in the Learning Disability category, not exceeding 10 service users in total. All service users work at the nearby Thorngrove Garden Centre, which is also operated by SCOPE. Such attendance is not a condition of residence. Residents can access reports by the Commission for Social Care Inspection via their notice board. Fees for the service, as of July 2006 range between £24,621.00 and £36,807.00 per annum. Variable additional charges are payable for holidays, hairdressing, toiletries, activities, trips, magazines/papers and public transport. Response to the Office of Fair Trading Report can be accessed via the following link: www.oft.gov.uk. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. All key standards were assessed according to the Care Home for Adults (18-65) National Minimum Standards. It took place over a two-day period in addition to four hours preparation. 10 service users were being accommodated at the time of this inspection. This report will refer to service users as residents as this is their preferred means of reference. A tour of the premises took place and lunch was taken with the residents at the Thorngove Garden Centre, where all the current residents work. The inspector spoke with the Interim Manager at length, staff on duty, an advocate and all residents during the visit. Various records were examined, including two resident’s case files. The Commission also received comment cards back from nine residents, three GP’s, two health professionals, six Care Managers and eight relatives. All responses received were extremely positive. The content of the responses were discussed fully at the inspection and pertinent comments incorporated within the report. An unannounced inspection had taken place on 21st November, 2005 establishing that service users continued to enjoy a high degree of satisfaction with the support and care provided, underpinned by a strong emphasis on equality, independence and human rights. All key standards were assessed at this inspection. What the service does well: The residents at Mulberry Court enjoy excellent outcomes. The home has an effective and thorough assessment and care planning process which involves the resident fully. Staff encourage a gradual path towards independence empowering residents to make informed choices and decisions about their lives. Residents participate fully in the running of the home, including decisions about meals, housework, trips, meaningful employment and education opportunities. The home excels in ensuring good relationships inside and outside the home are maintained. They also excel in offering spontaneous choice and variety of food, catering for any special dietary needs. Care plans detail the assessed health needs of residents and records seen also demonstrated evidence of good multi-disciplinary working taking place on a regular basis. The systems for the administration of medication are good with Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 6 clear, comprehensive arrangements in place to ensure resident’s medication needs are met. There are robust systems and policies in place in relation to complaints and for the protection of vulnerable adults. Mulberry Court offers a high standard of accommodation presenting a homely, comfortable yet spacious environment. The Interim Manager and his staff team are competent and confident in their jobs and enjoy excellent relationships with the residents. Comments received from health professionals, relatives, GP’s and residents were all extremely positive. Staff have a wealth of experience, with the majority suitably qualified and/or undertaking appropriate training. Staff also enjoy a high level of support which includes regular one to one supervision, group supervision attained in staff meetings, training opportunities, appraisal and development. The Manager oversees and monitors the service well and is committed to training, supervision and reflective practice which ensures positive outcomes for the residents. Despite the service being without a Registered Manager for some months the Interim Manager is congratulated on his continued commitment ensuring continuity of care for the residents. Both service users and staff spoke highly of his efforts. What has improved since the last inspection? Key-workers have used results from recent resident surveys to formulate action plans for individuals in order to continually improve the service provided. Work has been initiated and supported in order for more resident’s to self medicate. Training on race equality and anti-racism has taken place following a recommendation made at the last key inspection in August 2005. This topic remains on the rolling training schedule. Through positive recruitment campaigns, for workers with a disability, SCOPE in Gillingham, has been able to improve their ratio of workers with a disability to 32 . The Manager and staff at the home are continually looking at ways to improve the service. Surveys, reviews, staff meetings and house meetings are used as a means of identifying where improvements can be made and included within the Development Plan. Recent developments have included resident’s being more autonomous in the running of the home e.g. answering telephones, greeting visitors and shopping. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in the outcome area is good. This judgement has been made using evidence including a visit to this service. No new residents had been admitted within the last year so this standard was difficult to assess, however by examining care files it was clear that full assessments had been undertaken ensuring the service could meet the identified needs of individuals. EVIDENCE: SCOPE has a comprehensive admission and placement policy, including a preadmission assessment. From records seen, the home had obtained a Care Management Assessment in addition to completing an in-house assessment prior to admission. This assessment identified the care hours needed to meet the residents’ needs. The records demonstrated that the resident and the residents’ family had been involved in the assessments and admission. Care plans are then developed shortly after admission with input from the resident. Those seen had also been signed by the resident agreeing to the contents. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in the outcome area is excellent. This judgement has been made using evidence including a visit to this service. The care plans are comprehensive, up to date and the majority cross-reference to action plans, demonstrating that staff are conversant with the residents changing needs and personal goals and able to support them appropriately. The systems for resident consultation in this home are very good with a variety of evidence that indicates that residents’ views are sought and acted upon. The home has appropriate policies and procedures in place for assessing and managing risks, which are based on enabling residents to take responsible risks rather than preventing them from doing so. EVIDENCE: Two care files were examined in detail. Care files included an up to date Care Plan and Assessment. Through discussions with residents and staff it was clear that care plans are updated every six months with full participation of residents. The care plans seen were accurate, thorough and covered all areas Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 11 of personal and social support, associated health needs and a ‘working’ Action Plan. One of the action plans seen had no recording on any follow up action even though the resident concerned confirmed that action had taken place. A recommendation is therefore made to ensure staff record this important information. The care plans also include where specialist input is needed (i.e. physiotherapy or psychology), and how staff support residents in accessing these services. Care plans are written in the first person and set out both short term and long term goals based on the wishes and aspirations of the residents. One care plan seen was in large print to enable a partially sighted resident to read it. Evidence was seen and an advocate spoken with confirmed where staff have and are continuing to support a resident reach his goal of moving on. Residents spoken with confirmed that they could have a copy of their care plan if they so wished and knew what plans had been made following their Reviews. The Interim Manager and staff are proactive in promoting the rights of residents to make decisions and control their lives. There are no limitations placed on residents in relation to their choices or human rights. This was demonstrated by speaking with the residents, staff and by examining a variety of records. Staff provide information and assistance in order to support the residents to make their own choices and decisions. Examples include providing information on holidays, clubs, mobility aids, advocacy, travel and day opportunities. All residents manage their own finances. Of the nine comment cards received eight residents stated that they felt they had a ‘voice’ in decision making within the home. The home are able to demonstrate a variety of ways where residents have opportunities to be involved in the running of the home. These include one to one key sessions, monthly residents meetings, where minutes demonstrated that the running of the home is consistently discussed, being representative on the panel for recruiting staff. Key-workers have used results from recent resident surveys to formulate action plans for individuals in order to continually improve the service provided. Another initiative has involved the residents having more autonomy by answering the telephone, greeting visitors to the home and shopping. In more general terms the residents can easily access the senior management through the open door policy operated by the Interim Manager or by speaking with the visiting Regulation 26 visitor for the Company. The home has a comprehensive, user-focussed risk assessment policy and procedure in place. Risks are well documented and focus on enabling residents to continue to take responsible risks and maximise independence. Where, from the case files examined, risks had been identified following a needs assessment these had been duly recorded. As with care plans, risk assessments are updated every six months. Residents receive support and training, where necessary, such as Health and Safety training, road safety in relation to motorised wheelchairs and buggies, and personal safety when out in the local; and wider community. A member of the probation service had Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 12 recently visited the home to instruct on personal safety issues, which the residents reported as very useful. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in the outcome area is excellent. This judgement has been made using evidence including a visit to this service. Residents are well supported to take part in meaningful, appropriate jobs and education or training opportunities in order to achieve their full potential. Links with the community are good which support and enhance residents’ social and educational opportunities. The residents enjoy excellent relationships inside and outside the home and maintain good family links which enrich their lives. The daily routines promote independence and individual choice facilitating and supporting residents to achieve their individual goals. The meals in the home are excellent offering spontaneous choice and variety and catering for any special dietary needs. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 14 EVIDENCE: All the residents living at Mulberry Court undertake voluntary work at Thorngrove Garden Centre. This Garden Centre is owned and run by SCOPE. Various opportunities are available to the residents at the Garden Centre, either working in the coffee shop/restaurant, working in the plant shop, office or potting, growing and tending plants. The residents can choose how many days they work in the Garden Centre. Where residents request alternative work placements or educational opportunities their key-workers support them by contacting local agencies and employment services. Two residents currently living at Mulberry House visit other day service facilities on a ‘drop in’ basis. A number of residents also attend adult education courses at the local college for computers technology and literacy. One service user at another of SCOPE’s homes in Gillingham has, with the support from the previous Manager, developed a ‘Community File’ which describes all the local facilities in the area with accompanying photographs. The residents spoken with were fully aware of the local activities and support offered by specialist organisations and confirmed that staff assist them with gaining this information (for example PHAB club, DAB club, Riding for the Disabled, NorDis, Lifestyles and Stepping Stones). The care plans examined demonstrated that residents participate fully in the community, that they regularly go shopping, out for day trips, to the cinema, riding, pub and swimming. Although the majority of residents are independent and go out by themselves the home has the use of a car and a minibus to support residents in accessing community activities should they so wish. The needs of residents in relation to social and emotional well-being are very well documented and this standard is exceeded. Staff remain committed to supporting family links and friendships, but are also careful to ensure that residents determine who they see. The majority of residents have contact and friendships with disabled and non-disabled people and are encouraged to have friends and family to visit, including for dinner and/or parties. Support plans seen provided detailed information about social contacts and significant people in the lives of residents, and daily care records included entries relating to contact with families, friends and acquaintances. Staff are unable to fully support residents in intimate or personal relationships because SCOPE have yet to finalise/ratify their policy on ‘sexuality and personal relationships’. Although the previous Manager had reported at the last key inspection in August 2005 that he and a number of residents had been involved in a working group to develop appropriate policies on sexuality and personal relationships, this after some 18 months is still unavailable to staff and residents. A recommendation is therefore made for the second year Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 15 running for this policy and any appropriate training to be available in order for staff to guide and support residents appropriately. Each resident’s care plan sets out the agreed responsibilities in relation to housekeeping tasks. Some residents have opted out of regularly cooking and cleaning communal areas, whilst others have requested to cook the evening meals on some occasions. The majority of residents make their own breakfasts and lunches, do their own laundry and cleaning of their bedrooms (with varying levels of support and supervision). The house rules promote independence and individual choice. All residents have keys to their bedrooms and to the front door of the house and have unrestricted access to the communal areas and gardens. Residents confirmed that staff do not enter their rooms unless they give their permission. The menus seen confirmed that varied, balanced meals are provided. Alternative meals taken were accurately described on the menus and demonstrated where special diets are being catered for. Residents can choose where they eat their meals (either in the dining room, lounge or bedroom), although they choose to eat in the dining room for the majority of the time because they report the social interaction is good. Residents are involved in planning, preparing and cooking the meal if they choose to and all nine responses received from the comment cards confirmed that the residents like the food provided. The inspector observed an evening meal and took lunch with the residents at the Garden Centre. Staff were seen to be empowering residents to make choices, offering only minimal assistance in order for residents to gain greater autonomy. A new system for meal choice had been initiated which the residents felt was working well. Each week the residents have a choice of ten nutritionally balanced meals to choose from. Each resident takes it in turns to choose a meal. Previous to setting this programme up all residents were asked whether they liked or disliked over one hundred recipes. Records were made of responses and when the recipes were typed up and laminated alternatives for individuals were placed on each menu card in order for all residents to have a meal they enjoyed. Fresh produce is bought on a daily basis. This standard is exceeded. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in the outcome area is excellent. This judgement has been made using evidence including a visit to this service. Staff ensure consistency and continuity of support for residents through the allocation of designated key-workers, concise individual working records and partnerships with advocates, family, friends and relevant professionals. The health needs of the residents are assessed and well met with evidence of good multi-disciplinary working taking place on a regular basis. The systems for the administration of medication are good with clear, comprehensive arrangements being in place to ensure resident’s medication needs are met. EVIDENCE: Care plans demonstrated and residents confirmed that staff provide sensitive and flexible personal support in order to maximise their privacy, dignity and independence. Consistency and continuity of support is achieved through the allocation of designated key-workers and individual working records (for example the action plan) which set out preferred routines, likes and dislikes etc, Partnerships are also facilitated with advocates, family, friends and Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 17 relevant professionals, subject to the residents’ consent. Residents confirmed that they enjoy a flexible approach to when they go to bed, get up, when they bathe or partake in activities. They are encouraged to choose their own clothes, hairstyle etc., in order to reflect their individual personalities. It is not always possible to offer same gender support with personal or intimate tasks despite positive recruitment campaigns. The case files examined evidenced that the healthcare needs of residents are assessed and met within the home. The care plans set out the support needed to meet their needs. Although some residents are independent in accessing the doctor/dentists/optician others require some staff support. Any support offered is arranged with the focus on enabling residents to be as independent as possible, therefore support ranges from prompting to actually supervising and attending with the resident. Care files examined demonstrated that staff had made referrals to a variety of professionals on behalf of the residents. Residents have a choice of GP, although they all attend the local village surgery. Comment cards received from GP’s confirmed that they are able to see the residents in private and feel the care they receive at the home is good. Staff have received training in managing specific needs such as epilepsy. The home has a robust medication policy which had recently been reviewed and updated. All staff complete an induction in administering medication. This is an informal training session as part of SCOPE’s induction for new workers. A number of staff had completed a ‘Safe Handling in Medicines’ course and in addition the local Pharmacist provides specific training on medicines used in the home. Some new staff are currently awaiting this training. The Interim Manager reported good working relationships with the local Pharmacist. Medicines are kept securely in a locked cabinet. Some medicine is stored in a dedicated fridge, where staff monitor the temperature using a maximum and minimum thermometer. Accurate records were seen of medication administered, which had been signed off by two members of staff. Staff both record and receipt administration and return of medicines. When a resident who self-administers or when a resident takes medicine out of the home this is recorded in their Individual Working Record. The staff continue to encourage and support residents to retain and administer their own medication, following a multi-disciplinary risk assessment. The medication policy had recently been reviewed and updated. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in the outcome area is excellent. This judgement has been made using evidence including a visit to this service. The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. Robust systems and effective adult protection training ensures that residents are protected from abuse and that their welfare is being promoted. EVIDENCE: Observations made during the inspection clearly demonstrated that the views of the residents are listened to and acted upon. Further evidence of this was found in the minutes of house meetings and in Individual Working Records. All the residents spoken with knew who they could complain to, and were confident that any complaints would be addressed fairly. Information on how to complain is detailed in the homes ‘Statement of Purpose’, in the ‘Service User Guide’ and in a leaflet given to residents entitled ‘Complaining isn’t wrong – it’s a Right. There is also a notice on the resident’s notice board informing them how to complain if they are unhappy with the service provided. SCOPE also have a designated complaints officer to deal with residents/service users formal complaints. The Interim Manager reported that the service had received two complaints, which had been addressed satisfactorily, since the last inspection. Refresher training on ‘dealing with complaints’ had taken place in September 2005 and another session is booked for early 2007. The comment cards received from relatives and health professionals confirmed no complaints had been made against the home. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 19 SCOPE has robust policies and procedures in place and staff undertake regular training in relation to the protection of vulnerable adults. There is an identified adult protection officer at the Mulberry Court and an Adult Protection Team based at SCOPE’s Head Quarters. The Adult Protection Officer attends regional conferences on best practice and key issues relating to Adult Protection. A copy of the Local Interagency ‘No Secrets’ guidance was seen at the home. The Interim Manager reported that there had been two local level investigations on adult protection within the service but no interagency Adult Protection referrals since the last inspection. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 & 30 Quality in the outcome area is excellent. This judgement has been made using evidence including a visit to this service. The home is well designed, maintained and furnished to a high standard presenting the residents with a spacious, clean and homely environment. EVIDENCE: Mulberry Court is purpose built and designed to meet the needs of residents who have a physical disability. The property is owned by a housing association, who also undertake any repairs and routine maintenance. The accommodation for residents is on the ground floor with level access throughout the buildings and a well-designed garden. Mulberry Court comprises of two bungalows (one chalet style), accommodating five residents in each. Each bungalow has an open plan kitchen/diner, lounge, an adapted bathroom, a shower room and two toilets. Each resident has their own bedroom with a hand wash basin facility and doors that access a patio area. Both bungalows are furnished, decorated and maintained to a high standard. Records are kept of all renewals and repairs. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 21 The lounges, bedrooms and dining rooms are homely in style. A new shelving unit had been purchased for the dining area and a new DVD player, computer, digital camera and free-view box purchased for the lounge. Bathrooms and hallways are less domesticated, but continue to be welcoming, clean and bright. Bedrooms are all personalised which reflect individual personality. The premises are free from odours and on the days of inspection were extremely well presented, clean and tidy. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in the outcome area is excellent. This judgement has been made using evidence including a visit to this service. Staff have accurate job descriptions in order to ensure that the principles and ethos of the home are met. The majority of the staff team are well qualified, have suitable experience and are sufficient in number and competence to meet the needs of the individual residents. Robust systems for vetting and recruiting staff are in place allowing the most suitable, dedicated staff team to be recruited. Staff receive regular supervision, appraisal and development underpinned by a good training programme in order for them to deliver the best possible care to the residents. EVIDENCE: Staff files seen included accurate job descriptions that are clearly linked to achieving residents’ individual goals as set out in the Service User Plans. Staff spoken with demonstrated an awareness of their roles and responsibilities, including where it may be necessary to appropriately involve other agencies with more expertise. Observations demonstrated that staff seen working with residents all had positive relationships with the residents they were supporting. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 23 At the time of this inspection the majority of the care staff employed either have an NVQ2 or NVQ3 with the remainder working towards the awards. Two members of the staff team also hold the A1 Assessors Award. The inspector observed staff interacting well with the residents, being approachable and committed to the varying needs and abilities. Through discussions with staff and by reading various documentation staff have an awareness and understanding of the disabilities and specific conditions of the residents. Residents spoken with commented that they felt well cared for and fairly treated. The staff team are based at Mulberry Court but also work in the three other community homes run by SCOPE. The staffing rota adequately covers all four homes. The rotas demonstrated that there are at least two members of staff on duty on both the morning and evening shifts, excluding the Manager. The Interim Manager confirmed that staffing hours were flexible to ensure the resident’s needs are met. Residents spoken to felt that the staffing was adequate to their needs, acknowledging that at least half are very independent and have limited support. One staff personnel file was examined. This file demonstrated that a robust recruitment and selection procedure had been followed. A Criminal Record Bureau certificate had been obtained and two written references received. The staff member, had completed a detailed application form and listed their previous experience, work placements, qualifications and personal details. Notes of the interview are kept. Service users are involved in the selection and interview of new staff, and evidence of their participation was found in the personnel file examined. Proof of identity (including birth certificate and driving licence) had been copied and kept on their file. All applicants also have to complete a health declaration and give a medical history summary. Copies of the staff member’s contracts (terms and conditions of employment) and job descriptions are also held on file, and the newly appointed staff member spoken with was aware of these documents and stated that they had agreed and understood them. There is a six-month probationary period. SCOPE has developed an Induction and Foundation training pack for all new staff, which meet the ‘Skills for Care’ standards (previously TOPSS). The staff team not only work at Mulberry Court but also at three other community homes run by the organisation in Gillingham. SCOPE provide regular training for staff in all key areas (for example first aid, manual handling, food hygiene, adult protection, risk assessments). A training events calendar is produced annually and staff are also encouraged to undertake training courses external to this. The Interim Manager confirmed that staff are all up to date with mandatory training and random checks on the records of three members of staff further evidenced this. The training is linked to the home’s service aims Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 24 and to residents needs. For instance staff have received training in epilepsy, diabetes, disability equality and autism. Following a recommendation made at the last key inspection in August 2005 SCOPE have also run race equality training, an issue which is now part of their rolling programme of training. In addition well over 50 of the staff team hold their NVQ Level 2 award. The organisation is also funding a number of staff to undertake the NVQ level 3 award. Currently 32 of staff at Mulberry Court, covering all four services, have a disability clearly demonstrating SCOPE’s commitment both to issues of equality and to reinforcing positive role modelling for the residents. Each member of staff has a training needs assessment completed annually. Staff also confirmed and records seen further evidenced that staff receive regular supervision in order to enhance their skills and receive support and professional guidance. SCOPE has a detailed policy and procedures relating to formal supervision and appraisal of staff. The Interim Manager confirmed that he receives formal supervision by the regional SCOPE operations manager. The written records of supervision discussions confirmed that the sessions include the monitoring of the staff members work with individual service users, support and professional guidance, identification of training needs and discussions around the aims and objectives of the home. Staff meetings also provide group support and supervision. These occur bimonthly. The Interim Manager and Team Leaders have daily contact with staff. Staff spoken with confirmed that they receive a good level of support from their line managers and that supervision sessions are thorough. The Interim Manager and Team Leaders have received training in supervisory management. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in the outcome area is good. This judgement has been made using evidence including a visit to this service. The Interim Manager effectively runs and monitors the service ensuring the Statement of Purpose is fulfilled in practice. The open culture of his management style allows for positive direction and leadership. There are robust systems in place for monitoring the performance of the home against its’ Statement of Purpose and The Care Homes Regulations to ensure residents achieve good outcomes. The health, safety and welfare of the residents is promoted and protected by a huge variety of excellent risk assessments, good monitoring and recording systems and a trained staff team. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 26 EVIDENCE: The Interim Manager is currently applying to the Commission for Social Care Inspection (CSCI) for formal registration. Having been ‘Acting Up’ in the Managers role since April 2006 he has gained great respect from both staff and residents. All those concerned are aware that his post is temporary and that another Manager from another service, currently seconded, will be taking the helm early in 2007. In the mean time the Interim Manager is about to undertake his Registered Manager’s Award showing great commitment to the service and the residents. A requirement is made to ensure the Interim Manager’s application is received by the CSCI. There was evidence of continuous self monitoring, involving residents. Yearly reviews are carried out with the residents and their family/representatives/ friends. This review monitors how the residents’ goals and care plans have been achieved. In addition residents are formally asked their views about the service provided to them. The results from this years’ overall survey demonstrated that the service was performing at 3.3; 3 equalling good and 4 equalling excellent. This was slightly lower than last year and plans are to be formulated in order to address issues brought up for improvement. Regulation 26 visits are carried out monthly and copies of reports sent both to the home and to the Commission. A copy of the Annual Development Plan was also seen on the resident’s notice board. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement The application for the Interim Manager to be registered with the Commission for Social Care Inspection must be completed within the stated timescale. Timescale for action 1. YA37YA37 9.2 (1) 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6YA6 YA15YA15 Good Practice Recommendations All individual ‘Action Plans’ should be completed in order to demonstrate work carried out. Policies, which have been in draft for some 18 months, on sexuality and personal relationships should be verified and made available to staff in order for them to guide and support residents appropriately. Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mulberry Court DS0000026847.V313731.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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